Ultimate Guide to Practicing Medicine in the Cayman Islands

Imagine walking on white sandy beaches on your way home from clinic, snorkeling in clear waters surrounded by manta rays on your weekends, and SCUBA diving around the wrecks of HMS Kittiwake or the world-famous     Babylon.

The Cayman Islands, a British Overseas Territory just south of Cuba in the Caribbean Sea, are renowned for their stunning beaches, vibrant coral reefs, world-class diving, and luxury tourism. The country consists of three main islands: Grand Cayman, Cayman Brac, and Little Cayman. 

With a population of around 84,000 (a little under half of which are expats), the islands boast a high standard of living and are considered one of the most prosperous regions in the Caribbean. 

Cayman’s Healthcare System

The healthcare system is well-developed, offering both public and private healthcare services. Health Services Authority (HSA) manages the public healthcare sector, which includes the Georgetown Hospital in the capital and Faith Hospital in Cayman Brac. Private healthcare facilities, such as Health City Cayman Islands and Doctors Hospital as well as a number of outpatient clinics provide additional options for residents and visitors.

The quality of medical care is very high, almost every specialist is represented, and medical tourism is big business on the islands. Some physicians are FIFO (fly in fly out) and rotate OR/clinic times with a larger group. As a non-Caymanian, your work permit is connected to a clinic/Caymanian business owner, and your relationship with them will dictate your work hours/locations, etc. Over time you can apply for permanent residency and citizenship, though this will take several years.

For those interested in women’s health, abortion is illegal, though emergency contraception options are available over the counter, and all methods of contraception are available. Marijuana possession is treated very seriously (though they just had a referendum on this in 2025, lessening penalties for small amounts). One can prescribe CBD, though it is a restricted prescription along with benzodiazepines, stimulants, and opiates. There is a relationship with several American hospitals for pathology and some very specialized tests- for instance, my dermatopathology specimen go to Quest Diagnostics in Miami, although HSA and Health City have very sophisticated labs that I am touring soon.

Pharmacies order from US/American/Canadian/Indian suppliers to get any medications one needs, including biologics, and there is compounding on the island. 

Cayman does have a medical school, St. Matthew’s, though most are international students who will then perform their residency in their home countries- I heard an estimate that 20% are Canadian.

Medical Registration/Licensure

Cayman recognizes medical licenses from Canada, the US, the UK, South Africa, Australia and New Zealand, and those graduating from the University of the West Indies. You are eligible to apply for a Caymanian license once you are three years out of residency through the Medical and Dental Council (MDC).

You must have an active license and active CME in your home country in order to work here as there isn’t a college to which you pay annual dues. The criteria were recently increased to 50 CPD credits every 2 years and there are opportunities on island to collect these. Lots of people go to conferences in Miami, Atlanta, New York, or Toronto which are all direct flights (some longer than others!).

The application for licensure is cumbersome, requiring many small steps, professional references, character references, police check (with fingerprints- which is not specified on the form), lists of CME with certificates, passport photos, notarized copies of diplomas, English-language proof (or letter stating why you are exempt), medical certificate from your primary care doctor etc. 

It was a lot easier than my application to the GMC (medical licensing body in the UK), though, and all relatively straightforward when you have a clinic on the ground to help you. 

You can find the application and accompanying documents here: https://www.gov.ky/dhrs/mdc

Finding a Job

I’ve been here for 8 weeks only, so haven’t explored everything as of yet, but this is my experience.

Soon after graduating residency I cold e-mailed several clinics on Caribbean islands that I knew would accept my license. Two Caymanian clinics got back to me straight away as did a Bermudian one (who then stopped replying to me). The clinic I chose had had Canadians work with them before and were super enthusiastic. 

I had also spoken to a recruitment agency who organized a call with me right away, but gave me the erroneous information that I could apply one year out of residency, which isn’t true. I actually did apply based off this information, was rejected, and my expense and the clinic’s expense could have been avoided. As stated above, you need to be at least 3 years out of residency before MDC will grant your license.

Some helpful websites for local hospitals:

https://www.hsa.ky/careers

https://www.doctorshospital.ky/careers/

https://healthcitycaymanislands.com/careers/

Remember, it’s a small place! Cold-calling works. Everyone knows everyone and lots of jobs are found through word-of-mouth. I am happy to correspond with anyone who has questions!

Immigration

The work permit is very straightforward once you have a job. This is a big money-maker for the government as a huge number of foreign workers and expatriates are here working in medicine, child-care, hospitality, and the financial sectors.

You must have a confirmed job before the employer organizes the temporary work permit. This is usually good for 6 months and then after this time a regular work permit will be applied for. The work permit includes a medical that you can complete in your home country (including CXR, HIV/VDRL serology). I got the work permit less than a week after applying. Customs will have the official document when you land.

Salary

I make about the same as in my Canadian practice working ~4.5 days/week, though there is no income tax if you’ve cut ties with your home country, but the cost of living is higher. The Cayman dollar (CI$) is on par with the British pound.

There is a long history of expatriates living in Cayman in various sectors, and a helpful online and print magazine is Cayman Resident (www.caymanresident.com) which gives a breakdown on how to move here, immigration, and COL estimates.

Some recent job postings in the Cayman Islands include:

• OB/GYN at one of the island’s leading private hospitals (KYD 15,000–20,000/month)
• Anesthetist/Intensivist at the same hospital (KYD 16,000–20,000/month)
• Chief Medical Officer of the Cayman Islands, listed on BMJ (CI$163,164–189,204 per year)

Work Culture

I am having a great time and I look forward to going to work every day. I’ll let you know if this changes during the rainy season, as I do walk to clinic…

As a primary care physician with a special interest in skin cancer, I work about 40 hours a week plus every 5th Saturday morning. I have four weeks of vacation and ten days of sick leave, but I also get the impression that if I needed more time for a conference or personal reasons etc, it could be worked out.

I adore my colleagues and everyone I have referred to has been convivial, helpful, and interested in teaching and collaboration. I can get imaging for patients extremely fast, which I was awestruck by compared to Canada. I’m learning the nuances of charging insurance and I have never been so well-informed about CPT codes and how much individual tests cost (and how lucky Canadians are that our system absorbs this). It has given me a new perspective on efficiency, the cost of investigations, and private vs. public healthcare delivery.     

Living in Cayman 

Cayman has no income or property tax, though depending upon your country’s tax treaty, you may need to pay tax at home if not deemed a non-resident.

For U.S. citizens or US green card holders, you will need to file taxes in the US. You can learn more about expat taxes here. 

That being said, the cost of living is very high. Most food has to be imported as very little is grown here and all “creature-comfort” goods are imported. You can get essentially anything you want, but at a cost. Many people make regular visits to Miami (a 40-minute flight) for shopping.

Hurricane season (June-October) is a real thing and to be taken seriously.

There are many opportunities to get involved in the community. “Cayman Kind” is a motto, and represents the welcoming history, multiculturalism and friendliness of the islands. There are innumerable charity fundraisers, athletic runs/marathons/golf/sailing tournaments, and ecological conservation efforts (bat sighting documentation, blue iguana conservation, the parrot centre, Turtle Centre events etc). 

Being from Nova Scotia, I like participating in the beach clean-ups organized by @plasticfreecayman or the Chamber of Commerce and other groups, and I’ve met some great friends from around the world doing this.

So brush up on dengue symptoms, ciguatera poisoning, dive medicine and come practice in Cayman!    

👉 Ready to start your adventure? Grab your FREE Physician Starter Kit and see how to actually make life abroad happen.

Dr. Rosalind Ashton MD MSc CCFP (Family Physician) is from Nova Scotia and spent time in Greece and Turkey growing up. She went to medical school at Dalhousie University and then residency at the University of Ottawa. She also has an MSc in Clinical Dermatology from the St. John’s Institute of Dermatology at KCL in London, UK. Follow Instagram @rosieincayman for a very informal introduction to this sensational country. 

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